Nairobi Hospice

In June 2001 Nairobi Hospice, in collaboration with Oxford Brookes University, launched a 14 month Diploma in Higher Education Palliative Care. This part distance learning and part block system enables health care professionals from around Africa to undertake the diploma while continuing to work. The first class of students graduated in September 2002.

Jane Appleton , programme leader in palliative care at Oxford Brookes University, reflects on the course:

I first became involved in palliative care education in Kenya in around 1999; Brigid Sirengo the chief executive officer at Nairobi hospice had undertaken a course with Oxford Brookes University and my predecessor, Sue Duke, had kept in touch with Brigid and had visited Kenya. It was around 1999/2000 that we first began to think about the diploma in palliative care being delivered in Kenya, and that approach really came from Brigid Sirengo wanting to develop something more. The Nairobi hospice had already done a considerable amount of education, - introductory courses, Level 1 courses around the country and were interested in having a course at diploma or degree level. So the approach came from Brigid but it took a number of years to really get that going. We had a visit to Kenya to set up the details of the program and then the first course started in 2000. We’re on the third course now and we’re planning a fourth to start next year, I think.

The students came on the programme because they wanted to develop their knowledge and skills – and mostly the students we’ve had have been very experienced practitioners. They were not really new to palliative care; they had a lot of years experience but they were coming on the programme to develop further and to gain the recognised qualification. I think the diploma level was an incentive and the fact that the programme was very practice focused was another positive factor; and the range of students from different African countries - and disciplines - I think was another attraction.

We feel we have a programme that’s very student-centred, and that the programme is not content-driven particularly; it’s about working with the students where they are in their particular practice context. It is a practice-based course, so it wasn’t our context that drove it. Some of the key things we were trying to do were around trying to develop practitioners who were able to have a critical debate about palliative care practice - and that debate was very focused on the practice that they were engaged in.³⁶

Students from colleges and other hospices are offered 4 week clinical placements at Nairobi Hospice for palliative care experience. The hospice offers two separate training courses each lasting one week for healthcare professionals and community volunteers. During the year 2002-2003, 52 healthcare professionals and 68 volunteers completed these courses. Consultation is taking place with the Ministry of Health to include palliative care in the curriculum for nurse training.

The hospice provides introductory palliative care training to third year medical students at the teaching hospital.

Meru Hospice

While Meru Hospice does not provide any formal training there is informal teaching to final year student nurses at the Medical Training College, church groups, women and youth community groups, and health care providers at the district hospital. This covers principles of palliative care, principles of pain management and nursing management.

Eldoret Hospice

This hospice has yet to fully develop its own training programmes. In March 2004 a group of 18 participants including pastors, teachers and health professionals attended an initial training session for hospice volunteers.

Coast Hospice

In January 2004, 25 medical personnel (clinical officers and nurses) from the District Hospitals in the Coast Province were trained by this hospice in a 5 day palliative care course. The intention was to enable the trainees to set up small palliative care units in their respective stations with support provided by the hospice. “As we are charged with the responsibility of providing palliative care to patients in the whole province, we find that not only is this not practical but we would also be spreading our already skeleton staff too thin hence the annual training programme”.³⁷ Plans are in place for similar workshops in 2005 for health workers and volunteers.